Healthcare Provider Details

I. General information

NPI: 1235114273
Provider Name (Legal Business Name): ROBIN R WATSON MSN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ROBIN L JOHNSTON

II. Dates (important events)

Enumeration Date: 12/13/2005
Last Update Date: 04/07/2022
Certification Date: 04/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 WASHINGTON ST EASTERN CT HEMATOLOGY & ONCOLOGY SUITE 220
NORWICH CT
06360-2700
US

IV. Provider business mailing address

12 CASE ST STE 212
NORWICH CT
06360-2222
US

V. Phone/Fax

Practice location:
  • Phone: 860-886-8362
  • Fax: 860-886-9262
Mailing address:
  • Phone: 860-859-9123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number002940
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number002940
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: